Provider Demographics
NPI:1598973703
Name:R & D HOME CARE, INC. - GOLDEN CARE HOME
Entity Type:Organization
Organization Name:R & D HOME CARE, INC. - GOLDEN CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-329-8853
Mailing Address - Street 1:16221 S MENLO AVE
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-4929
Mailing Address - Country:US
Mailing Address - Phone:310-329-8853
Mailing Address - Fax:310-768-1338
Practice Address - Street 1:507 W 157TH ST
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-2108
Practice Address - Country:US
Practice Address - Phone:310-768-2844
Practice Address - Fax:310-768-1338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities